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Published on: January 31, 2019
Variation between Clinician-Recorded and Downloaded Invasive Blood Pressure in Extremely Preterm Infants
Sujith S Pereira1,2, Ajay K Sinha2,3, Divyen K Shah3,4
1Neonatal Unit, Homerton University Hospital, Homerton Healthcare National Health Services Foundation Trust, London, United Kingdom.
Objective:
This study aimed to examine the variation between clinician-recorded and continuously downloaded invasive blood pressure (BP).
Study Design:
Prospective study where invasive BP data were downloaded every 10 seconds for the first week of life. Hourly clinician-recorded BP was recorded. Agreement between the two methods were examined.
Results:
A total of 1,180 BP measurements were examined from 42 preterm infants with a mean (standard deviation [SD]) gestation and birthweight of 25.7 weeks (1.4) and 802 g (177) respectively. The mean (SD) bias was -0.11 mm Hg (3.17), but the 95% limits of agreement (LOA) varied between -6.3 and +6.1 mm Hg. Inotrope usage was significantly higher for BP measurements that fell in the 5% outliers when compared with those that fell within the 95% LOA (62.7 vs. 44.6%, p = 0.006).
Conclusion:
Clinicians showed no systematic bias to over- or underrecord BP, but some of the greatest differences were found in infants receiving inotropes.
Key Points:
· BP is a commonly recorded cardiovascular parameter in the neonatal intensive care unit.. · Invasively measured BP remains the gold standard.. · Clinician-recorded BP showed no systematic bias in over-or underrecording invasive BP..
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